MRS. Desra Mack, LPC
NPI #1588761530 in Elizabeth City, North Carolina
Provider Information
- NPI Number
- 1588761530
- Entity Type
- Individual
- Name
- MRS. Desra Mack, LPC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Professional
- Credential
- LPC
- Enumeration Date
- Sep 20, 2006
- Last Updated
- Mar 1, 2011
Practice Location
- Address
- 1141 N ROAD ST
- Address 2
- SUITE L
- City
- Elizabeth City
- State
- North Carolina
- ZIP Code
- 27909-3354
- Phone
- (252) 335-0803
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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